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Left atrial spindle cell sarcoma: a case report
BACKGROUND: Primary cardiac spindle cell sarcomas are extremely rare with only a few cases reported. They are frequently misdiagnosed on cardiac magnetic resonance (CMR) imaging as benign myxoma or thrombi and the suspicion of a malignant sarcoma arises only during surgery. This case report describe...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439379/ https://www.ncbi.nlm.nih.gov/pubmed/31020250 http://dx.doi.org/10.1093/ehjcr/ytz005 |
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author | Braams, Natalia J Kaffka Genaamd Dengler, Selma E Rutten, Emma G G M de Boer, Karin |
author_facet | Braams, Natalia J Kaffka Genaamd Dengler, Selma E Rutten, Emma G G M de Boer, Karin |
author_sort | Braams, Natalia J |
collection | PubMed |
description | BACKGROUND: Primary cardiac spindle cell sarcomas are extremely rare with only a few cases reported. They are frequently misdiagnosed on cardiac magnetic resonance (CMR) imaging as benign myxoma or thrombi and the suspicion of a malignant sarcoma arises only during surgery. This case report describes a case of cardiac spindle cell sarcoma diagnosed after surgery, where the initial diagnostic possibilities included an intramural thrombus and a cardiac myxoma. CASE SUMMARY: A 57-year-old woman was referred to our hospital for evaluation of a possible recurrent myxoma in the left atrium on echocardiography. Cardiac magnetic resonance imaging confirmed these masses as mural thrombotic masses, with a possible remnant of myxoma. After 2 months of anticoagulation therapy, the masses did not decrease in size on CMR imaging, and surgical removal was indicated. The atrial masses were surgically resected together with a large part of the left atrium. Histological examination showed spindle cell sarcoma. Unfortunately, the resection margins were positive and it was not possible to remove more atrium. PET-CT revealed metastasis in the right femur. The patient passed away 1 year after surgery. DISCUSSION: The rarity of spindle cell sarcoma and its similarities to benign cardiac myxoma and thrombi on echocardiography and CMR imaging present a diagnostic challenge when evaluating patients pre-operatively. Therefore, a malignant spindle cell sarcoma may only be diagnosed during surgery, after histological examination. |
format | Online Article Text |
id | pubmed-6439379 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-64393792019-04-24 Left atrial spindle cell sarcoma: a case report Braams, Natalia J Kaffka Genaamd Dengler, Selma E Rutten, Emma G G M de Boer, Karin Eur Heart J Case Rep Case Reports BACKGROUND: Primary cardiac spindle cell sarcomas are extremely rare with only a few cases reported. They are frequently misdiagnosed on cardiac magnetic resonance (CMR) imaging as benign myxoma or thrombi and the suspicion of a malignant sarcoma arises only during surgery. This case report describes a case of cardiac spindle cell sarcoma diagnosed after surgery, where the initial diagnostic possibilities included an intramural thrombus and a cardiac myxoma. CASE SUMMARY: A 57-year-old woman was referred to our hospital for evaluation of a possible recurrent myxoma in the left atrium on echocardiography. Cardiac magnetic resonance imaging confirmed these masses as mural thrombotic masses, with a possible remnant of myxoma. After 2 months of anticoagulation therapy, the masses did not decrease in size on CMR imaging, and surgical removal was indicated. The atrial masses were surgically resected together with a large part of the left atrium. Histological examination showed spindle cell sarcoma. Unfortunately, the resection margins were positive and it was not possible to remove more atrium. PET-CT revealed metastasis in the right femur. The patient passed away 1 year after surgery. DISCUSSION: The rarity of spindle cell sarcoma and its similarities to benign cardiac myxoma and thrombi on echocardiography and CMR imaging present a diagnostic challenge when evaluating patients pre-operatively. Therefore, a malignant spindle cell sarcoma may only be diagnosed during surgery, after histological examination. Oxford University Press 2019-02-06 /pmc/articles/PMC6439379/ /pubmed/31020250 http://dx.doi.org/10.1093/ehjcr/ytz005 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Reports Braams, Natalia J Kaffka Genaamd Dengler, Selma E Rutten, Emma G G M de Boer, Karin Left atrial spindle cell sarcoma: a case report |
title | Left atrial spindle cell sarcoma: a case report |
title_full | Left atrial spindle cell sarcoma: a case report |
title_fullStr | Left atrial spindle cell sarcoma: a case report |
title_full_unstemmed | Left atrial spindle cell sarcoma: a case report |
title_short | Left atrial spindle cell sarcoma: a case report |
title_sort | left atrial spindle cell sarcoma: a case report |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439379/ https://www.ncbi.nlm.nih.gov/pubmed/31020250 http://dx.doi.org/10.1093/ehjcr/ytz005 |
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